>	Board of Health Reviews Public Health Program Cuts to Address Deficit

Proposed Service Reductions to Mitigate Deficits
Larimer County Dept. of Health and Environment
Summary of Cuts

Reduce		Eliminate
Family Planning Health Care Program for Children with Special Needs Immunizations Prenatal Risk Reduction for Low-Income Women Health Ed/Public Information Clerical services, reducing office hours in Fort Collins, Loveland, and Estes Park.		Restaurant, School Cafeterias, and Grocery Store Inspections Injury Prevention Growth Clinic Adult Wellness Pollution Prevention EAB support Hazardous Wastes and Leaking Underground Tanks

Impact From Proposed Reductions

• We will be able to provide considerably less in the way of core public health services to our community in 2003 compared to 2002. We will have staffing levels for these services that existed in the 1970's, when the population we served was considerably smaller. Among the effects of these cuts are:
• Approximately 259 women will not receive family planning services. All county dollars supporting family planning will be eliminated.
• Over 6,000 children may not receive information and equipment to prevent injuries, the leading cause of childhood deaths in Larimer County.
• Several infants who are not growing adequately for their age are likely to be placed in out-of-home foster care because Growth Clinic services are not available to their parents.
• Families of disabled children will have fewer resources (36% less FTE) to help them access needed services, as all county dollars are eliminated from this program.
• Over 1,000 immunizations will not be given to children, as 0.2 FTE are eliminated, and clinic hours are cut back.
• Five to six hundred women will not receive the prenatal risk reduction services which prevented about 40 low birth weight babies in 2001 and saved our health care systems over $1,000,000.
• 900 people will not receive pollution prevention information to help prevent the creation of pollutants in businesses and homes.
• There will be no local capacity for responding to hazardous waste problems or leaking underground storage tanks. The state health department will only be able to respond to large spills or contamination problems.
• There will be no local food safety program. Responsibility for licensing and inspection over 1,100 establishments will be given back to the state, which currently deals with only 500 establishments statewide.
• Loss of administrative support staff for the clinics and the business office will lead to fewer hours of service, reduced ability to provide backup for sick and vacation leaves, and potentially the loss of our ability to do cost allocation for our programs.

NEWS RELEASE

CONTACT: Marie Kincher, Larimer County Dept. of Health and Environment
(970) 498-6711

DATE: June 27, 2002

SUBJECT: Board of Health Reviews Public Health Program Cuts to Address Deficits

At the Larimer County Board of Health meeting this evening, the Board reviewed the Health Department's proposal for reducing and eliminating public health services in order to address the budget deficit. The drastic cuts resulted from the combination of the Governor's veto of the entire state per capita line item for local health departments on top of a pre-existing shortfall in the 2002 budget. Overall, a list of $700,000 in cuts were included, although the department managers hope that $600,000 will be enough.

Among the proposed program reductions are the Family Planning Program, the Prenatal Plus/Maternity Program, and the Health Care Program for Children with Special Needs, all of which will lose all county dollars from their support, and operate on whatever grant money may remain after the cuts. Immunization clinics, Health Education/Public Information, and clerical support will also be reduced.

Proposed for elimination are the Food Safety Program (Restaurant/grocery store licensing and inspections), the Injury Prevention Program, Growth Clinic, Adult Wellness Clinic, Pollution Prevention, Hazardous Waste and Underground Storage Tank Inspections, and staff support to the Environmental Advisory Board.

"Because per capita and county dollars fund our core public health services, there were no good choices to be made. Every cut increases the risk of disease and death in the county, and will cost the community far more than keeping the programs intact," said Dr. Adrienne LeBailly, the department director. "This is the saddest day of my public health career."

The Board heard the reduction proposals tonight, but will not make any final decision on the specific cuts until the July 18 Board of Health Meeting. The Board of Health will also be meeting on that date with the Larimer County Board of Commissioners, and will ask the Commissioners to consider referring a ballot initiative to the voters in November to let them decide if they want to keep these public health services. The costs of restoring these public health programs is estimate at about 0.3 mills, or about $5.12 additional tax on a $200,000 home.

Written comments on the proposed reductions can be sent to the Board of Health by mail (1525 Blue Spruce Drive, Fort Collins, CO, 80524), by e-mail at boh@co.larimer.co.us, or on the web at www.larimer.org/health. Comments can also be sent to the Commissioners office, who will forward the responses on to the Board of Health. Please send comments to the Board by July 8, 2002.

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A prior press release from June 10, with more background information, follows below:

June 10, 2002 NEWS RELEASE
- FOR IMMEDIATE RELEASE--

The Governor's recent veto of the entire $5 million of Colorado's "per capita" funding for local public health departments will profoundly affect our local public health services, according to Dr. Adrienne LeBailly, Director of the Larimer County Department of Health and Environment. Our core public health services, such as immunizations, prenatal services, food safety, drinking water and waste water programs, among others, are most at risk.

By law, the state per capita funding is allocated to the 15 organized health departments in Colorado serving 88% of Colorado's population, and is based on the population served by the departments. The overall per capita funding loss to Larimer County was about $355,000 (about $26,000 cut by the legislature, and $329,000 from the governor's veto). These cuts go into effect on July, 1, 2002. In addition, the governor has ordered a 4% reduction in general funds to all state departments, some of which will likely be passed on to local health departments in program grant cuts. "Our best guess is this might be another $50,000, for a estimated total of $400,000 in state cuts," said LeBailly

These cuts are on top of an estimated $200,000 shortfall in the current budget the department was facing before the governor's veto. "We had hoped to make up for these losses by increasing our fees, and moving staff responsibilities to fulfill the anticipated work on the federal bioterrorism grant when it became available. We also had a healthy fund balance at the beginning of the year. Now, facing an anticipated total deficit of $600,000 or more, drastic cuts in programs that aren't funded by special grants will need to occur. Unfortunately, we will be losing up to 25% of our core public health services," said LeBailly

The Larimer County Board of Health will meet on June 27 to make the difficult decisions on how to trim services to fit the revenues. Their recommendations will then be presented to the Larimer County Commissioners at a joint meeting on July 18. Additional funds could be requested from the commissioners in the form of a mill levy increase, which would have to go for voter approval. Public health managers are exploring outside sources of funds from private foundations and other possible sources. The short time frame and the many other programs hit by the governor's veto reduce the chances of success in this endeavor.

Some health department fees will be increased by 50% or more, but even with these increases, services will have to be cut significantly. "We will immediately begin reducing costs by not filling vacant positions, reducing travel and training, and delaying non essential purchases," LeBailly said

All activities that receive county tax dollars are at risk. In addition to general department administration and management, these would include:

· Disease outbreak investigation and communicable disease control
· Environmental health programs, including air and water quality protection, food safety, solid and hazardous waste control, environmental health-related land use planning, emergency response to incidents and disasters, such as spills and floods, and safety/sanitation inspections of schools, day care centers, institutions, and camps.
· Community health services such as immunization clinics for children and adults; tuberculosis control, prenatal services to low-income pregnant women, care coordination, screening, and referral for disabled children, some family planning and sexually transmitted disease services, health education, child health services, and childhood injury prevention.

Overall a cut of 10-15 full time employees is anticipated to make up for the shortfall. While the federal Bioterrorism grant the state just received might bring 2 or 3 positions to the department, it will not make up for the losses, nor can the money be used for the services that may be lost.

"The bioterrorism money would have been a welcome addition to strengthen local public health agencies, but it was never intended to cover core public health services," said LeBailly. "Now I have some very mixed feelings about it."

"The increases in disease, injury, and death that will come to our county as a result of these cuts is almost certain to exceed the harm ever caused by bioterrorists in our county. The net result is that our public health services will be in worse shape soon than they were before September 11."

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